Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children's Depression Inventory and Spielberger's State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.

OBJECTIVES: Psychological factors may be the underlying causes in unexplained chest pain (UCP). Chest pain symptom may influence the emotional status and peer relationships of the children and adolescents negatively. However, the number of studies focussing on the aetiology and consequences of the adolescent UCP are still limited. The aim of this study is to investigate the relationships among psychological problems, attachment characteristics, and the UCP in a group of adolescents. METHODS: Seventy-three adolescents with UCP and seventy-one healthy adolescents were included in the study. The adolescents completed the short form of Inventory of Parent and Peer Attachment (s-IPPA), and Strengths and Difficulties Questionnaire (SDQ), while their parents completed the parental form of the SDQ. RESULTS: Contrary to expectations, there was no significant interaction between total parental attachment levels and UCP in the adolescents with UCP. There were significant correlations between the attachment problems and total difficulties score of SDQ. Binary logistic regression analysis revealed that higher emotional and conduct problems and lower prosocial characteristics predict the UCP in adolescents, significantly. CONCLUSIONS: The results suggested that emotional/behavioural problems and lower prosocial behaviour scores are associated with UCP. However, further studies are needed for better understanding about the relationships between the UCP and attachment quality. ARTICLE HISTORY

Objective: To evaluate the relationship between blood pressure changes monitored by 24-hour blood pressure measurements and urinary incontinence in children with enuresis. Method: The patients aged 5-18 years who received (patient group), and did not receive (control group) the diagnosis of primary monosymptomatic enuresis, and applied between January 01, 2017 and June 1, 2017, to the outpatient clinics of Izmir Tepecik Training and Research Hospital Department of Pediatric Nephrology and Pediatrics constituted the study group. Demographic data, height, body weight, body mass index, family history of chronic illness, and enuresis, drug use, laboratory test results (blood biochemistry and whole blood count) and ambulatory blood pressure monitoring (ABPM) measurements were compared between groups. Results: Thirty-five (62.5%, Group 1) patients and 21 (37.5%, Group 2) control subjects were included in the study. Demographic properties of the patients were not remarkable. Family history of enuresis was detected in statistically significantly greater number of patients (p=0.001). Any statistically significant difference was not noted when ABPM data of both groups were compared. Conclusion: Discrepancies in the results of various studies concerning the autonomic system changes in enuretic patients, their reflections on blood pressures, and 24-hour blood pressure profiles, in addition to controversial views of the authors about relationship between decreasing urine output and BP depression have necessitated conduction of further studies with larger group of patients.